PMID- 33135851
OWN - NLM
STAT- MEDLINE
DCOM- 20210217
LR  - 20210223
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 22
IP  - 12
DP  - 2020 Dec
TI  - In-hospital care in acute heart failure during the COVID-19 pandemic: insights 
      from the German-wide Helios hospital network.
PG  - 2190-2201
LID - 10.1002/ejhf.2044 [doi]
AB  - AIMS: The coronavirus disease 2019 (COVID-19) pandemic has led to changes in 
      health care utilization for different acute cardiovascular diseases. Whether 
      hospitalization rates and in-hospital mortality were affected by the pandemic in 
      patients with acute symptomatic heart failure (HF) was investigated in this 
      study. METHODS AND RESULTS: Administrative data provided by 67 German Helios 
      hospitals were examined for patients with a main discharge diagnosis of HF using 
      ICD codes. Urgent hospital admissions per day were compared for a study period 
      (13 March-21 May 2020) with control intervals in 2020 (1 January-12 March) and 
      2019 (13 March-21 May), resulting in a total of 13 484 patients excluding all 
      patients with laboratory-proven COVID-19 infection. Incidence rate ratios (IRR) 
      were calculated using Poisson regression. Generalized linear mixed models were 
      used for univariable and multivariable analysis to identify predictors of 
      in-hospital mortality. The number of admissions per day was lower in the study 
      period compared to the same year [IRR 0.69, 95% confidence interval (CI) 
      0.67-0.73, P < 0.01] and the previous year control group (IRR 0.73, 95% CI 
      0.70-0.76, P < 0.01). Age was similar throughout the intervals, but case severity 
      increased in terms of distribution within New York Heart Association (NYHA) 
      classes and comorbidities. Within the study period, 30-day rates for urgent 
      hospital readmissions were higher compared to the same year but not the previous 
      year control group. In-hospital mortality was 7.3% in the study period, 6.1% in 
      the same year (P = 0.03) and 6.0% in the previous year control group (P = 0.02). 
      In multivariable analysis, age, NYHA class and other predictors of fatal outcome 
      were identified but hospitalization during the study period was not independently 
      associated with mortality. CONCLUSION: Our data showed a significant reduction of 
      urgent hospital admissions for HF with increased case severity and concomitant 
      in-hospital mortality during the COVID-19 pandemic in Germany. Identifying causes 
      of reduced inpatient treatment rates is essential for the understanding and 
      valuation with regard to future optimal management of patients with HF.
CI  - (c) 2020 The Authors. European Journal of Heart Failure published by John Wiley & 
      Sons Ltd on behalf of European Society of Cardiology.
FAU - Konig, Sebastian
AU  - Konig S
AD  - Department of Electrophysiology, Heart Center Leipzig at University Hospital, 
      Leipzig, Germany.
AD  - Leipzig Heart Institute, Leipzig, Germany.
FAU - Hohenstein, Sven
AU  - Hohenstein S
AD  - Leipzig Heart Institute, Leipzig, Germany.
FAU - Meier-Hellmann, Andreas
AU  - Meier-Hellmann A
AD  - Helios Hospitals, Berlin, Germany.
FAU - Kuhlen, Ralf
AU  - Kuhlen R
AD  - Helios Health, Berlin, Germany.
FAU - Hindricks, Gerhard
AU  - Hindricks G
AD  - Department of Electrophysiology, Heart Center Leipzig at University Hospital, 
      Leipzig, Germany.
AD  - Leipzig Heart Institute, Leipzig, Germany.
FAU - Bollmann, Andreas
AU  - Bollmann A
AD  - Department of Electrophysiology, Heart Center Leipzig at University Hospital, 
      Leipzig, Germany.
AD  - Leipzig Heart Institute, Leipzig, Germany.
CN  - Helios Hospitals, Germany
LA  - eng
PT  - Journal Article
DEP - 20201202
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
SB  - IM
CIN - Eur J Heart Fail. 2020 Dec;22(12):2202-2204. PMID: 33247614
MH  - Acute Disease
MH  - Aged
MH  - COVID-19/*epidemiology
MH  - Female
MH  - Germany/epidemiology
MH  - Heart Failure/*epidemiology/therapy
MH  - Hospital Mortality/*trends
MH  - Hospitalization/*trends
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multi-Institutional Systems
MH  - Multivariate Analysis
MH  - Patient Readmission/trends
MH  - SARS-CoV-2
MH  - Severity of Illness Index
OTO - NOTNLM
OT  - COVID-19
OT  - Heart failure
OT  - Hospitalization
OT  - In-hospital mortality
OT  - SARS-CoV-2
EDAT- 2020/11/03 06:00
MHDA- 2021/02/18 06:00
CRDT- 2020/11/02 08:43
PHST- 2020/08/14 00:00 [received]
PHST- 2020/10/09 00:00 [revised]
PHST- 2020/10/29 00:00 [accepted]
PHST- 2020/11/03 06:00 [pubmed]
PHST- 2021/02/18 06:00 [medline]
PHST- 2020/11/02 08:43 [entrez]
AID - 10.1002/ejhf.2044 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2020 Dec;22(12):2190-2201. doi: 10.1002/ejhf.2044. Epub 2020 
      Dec 2.